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General NPI Number Information
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NPI Number | 1023204948
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NORTHERN COLORADO
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 10TH AVE AND 19TH ST CAMPUS BOX 6
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City | GREELEY
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State | CO
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Zip | 80639-0001
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Country | US
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Telephone | 970-351-1876
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Fax |
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Provider Business Mailing Address
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Address Line | 10TH AVE AND 19TH ST CAMPUS BOX 6
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City | GREELEY
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State | CO
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Zip | 80639-0001
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Country | US
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Telephone | 970-351-1876
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Fax |
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Authorized Official
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Title or Position | VP FOR ADMINISTRATION
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Name | MR. RANDAL HAACK
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Credential |
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Telephone | 970-351-2772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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